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Comparison of maternal and fetal outcomes among Asian Indian pregnant women with or without gestational diabetes mellitus: A situational analysis study (WINGS-3)
AIM: To compare the existing maternal and fetal outcomes in Asian Indian women with or without gestational diabetes mellitus (GDM) before the development of the Women in India with GDM Strategy (WINGS) GDM model of care (MOC). MATERIALS AND METHODS: Records of pregnant women were extracted retrospec...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Medknow Publications & Media Pvt Ltd
2016
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4911838/ https://www.ncbi.nlm.nih.gov/pubmed/27366715 http://dx.doi.org/10.4103/2230-8210.183469 |
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author | Mahalakshmi, Manni Mohanraj Bhavadharini, Balaji Maheswari, Kumar Kalaiyarasi, Gunasekaran Anjana, Ranjit Mohan Ranjit, Unnikrishnan Mohan, Viswanathan Joseph, Kurian Rekha, Kurian Nallaperumal, Sivagnanam Malanda, Belma Kayal, Arivudainambi Belton, Anne Uma, Ram |
author_facet | Mahalakshmi, Manni Mohanraj Bhavadharini, Balaji Maheswari, Kumar Kalaiyarasi, Gunasekaran Anjana, Ranjit Mohan Ranjit, Unnikrishnan Mohan, Viswanathan Joseph, Kurian Rekha, Kurian Nallaperumal, Sivagnanam Malanda, Belma Kayal, Arivudainambi Belton, Anne Uma, Ram |
author_sort | Mahalakshmi, Manni Mohanraj |
collection | PubMed |
description | AIM: To compare the existing maternal and fetal outcomes in Asian Indian women with or without gestational diabetes mellitus (GDM) before the development of the Women in India with GDM Strategy (WINGS) GDM model of care (MOC). MATERIALS AND METHODS: Records of pregnant women were extracted retrospectively from three maternity centers in Chennai. GDM was diagnosed using the International Association for Pregnancy Study Groups criteria or the Carpenter and Coustan criteria. Demographic details, obstetric history, antenatal follow-up, treatment for GDM, and outcomes of delivery were collected from the electronic medical records. RESULTS: Of the 3642 records analyzed, 799 (21.9%) had GDM, of whom 456 (57.1%) were treated with insulin and medical nutrition therapy (MNT), 339 (42.4%) with MNT alone, and 4 (0.5%) with metformin. Women with GDM were older than those without (28.5 ± 4.5 vs. 27.1 ± 4.5 years; P < 0.001) and had higher mean body mass index at first booking (26.4 ± 5.2 kg/m(2) vs. 25.2 ± 5.1 kg/m(2); P < 0.001). Rates of cesarean section (26.2% vs. 18.7%; P < 0.001), preeclampsia (1.8% vs. 0.8%; P = 0.04), and macrosomia (13.9% vs. 10.8%; P = 0.02) were significantly higher among women with GDM. In women with GDM treated with insulin and MNT, emergency cesarean section (16.2% vs. 36.6%; P < 0.0001), preeclampsia (0.7% vs. 3.2%; P = 0.015), and macrosomia (9.9% vs. 18.6%; P = 0.0006) were significantly lesser compared to those treated with MNT alone. CONCLUSION: Pregnancy outcomes were in general worse in GDM women. Treatment with insulin was associated with a significantly lower risk of complications. However, in countries with limited access to insulin and other medicines may lead to poor follow-up and management of GDM. Data from this retrospective study will form the basis for the development of the WINGS GDM MOC, which will address these gaps in GDM care in low-resource settings. |
format | Online Article Text |
id | pubmed-4911838 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-49118382016-07-01 Comparison of maternal and fetal outcomes among Asian Indian pregnant women with or without gestational diabetes mellitus: A situational analysis study (WINGS-3) Mahalakshmi, Manni Mohanraj Bhavadharini, Balaji Maheswari, Kumar Kalaiyarasi, Gunasekaran Anjana, Ranjit Mohan Ranjit, Unnikrishnan Mohan, Viswanathan Joseph, Kurian Rekha, Kurian Nallaperumal, Sivagnanam Malanda, Belma Kayal, Arivudainambi Belton, Anne Uma, Ram Indian J Endocrinol Metab Original Article AIM: To compare the existing maternal and fetal outcomes in Asian Indian women with or without gestational diabetes mellitus (GDM) before the development of the Women in India with GDM Strategy (WINGS) GDM model of care (MOC). MATERIALS AND METHODS: Records of pregnant women were extracted retrospectively from three maternity centers in Chennai. GDM was diagnosed using the International Association for Pregnancy Study Groups criteria or the Carpenter and Coustan criteria. Demographic details, obstetric history, antenatal follow-up, treatment for GDM, and outcomes of delivery were collected from the electronic medical records. RESULTS: Of the 3642 records analyzed, 799 (21.9%) had GDM, of whom 456 (57.1%) were treated with insulin and medical nutrition therapy (MNT), 339 (42.4%) with MNT alone, and 4 (0.5%) with metformin. Women with GDM were older than those without (28.5 ± 4.5 vs. 27.1 ± 4.5 years; P < 0.001) and had higher mean body mass index at first booking (26.4 ± 5.2 kg/m(2) vs. 25.2 ± 5.1 kg/m(2); P < 0.001). Rates of cesarean section (26.2% vs. 18.7%; P < 0.001), preeclampsia (1.8% vs. 0.8%; P = 0.04), and macrosomia (13.9% vs. 10.8%; P = 0.02) were significantly higher among women with GDM. In women with GDM treated with insulin and MNT, emergency cesarean section (16.2% vs. 36.6%; P < 0.0001), preeclampsia (0.7% vs. 3.2%; P = 0.015), and macrosomia (9.9% vs. 18.6%; P = 0.0006) were significantly lesser compared to those treated with MNT alone. CONCLUSION: Pregnancy outcomes were in general worse in GDM women. Treatment with insulin was associated with a significantly lower risk of complications. However, in countries with limited access to insulin and other medicines may lead to poor follow-up and management of GDM. Data from this retrospective study will form the basis for the development of the WINGS GDM MOC, which will address these gaps in GDM care in low-resource settings. Medknow Publications & Media Pvt Ltd 2016 /pmc/articles/PMC4911838/ /pubmed/27366715 http://dx.doi.org/10.4103/2230-8210.183469 Text en Copyright: © Indian Journal of Endocrinology and Metabolism http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution NonCommercial ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Mahalakshmi, Manni Mohanraj Bhavadharini, Balaji Maheswari, Kumar Kalaiyarasi, Gunasekaran Anjana, Ranjit Mohan Ranjit, Unnikrishnan Mohan, Viswanathan Joseph, Kurian Rekha, Kurian Nallaperumal, Sivagnanam Malanda, Belma Kayal, Arivudainambi Belton, Anne Uma, Ram Comparison of maternal and fetal outcomes among Asian Indian pregnant women with or without gestational diabetes mellitus: A situational analysis study (WINGS-3) |
title | Comparison of maternal and fetal outcomes among Asian Indian pregnant women with or without gestational diabetes mellitus: A situational analysis study (WINGS-3) |
title_full | Comparison of maternal and fetal outcomes among Asian Indian pregnant women with or without gestational diabetes mellitus: A situational analysis study (WINGS-3) |
title_fullStr | Comparison of maternal and fetal outcomes among Asian Indian pregnant women with or without gestational diabetes mellitus: A situational analysis study (WINGS-3) |
title_full_unstemmed | Comparison of maternal and fetal outcomes among Asian Indian pregnant women with or without gestational diabetes mellitus: A situational analysis study (WINGS-3) |
title_short | Comparison of maternal and fetal outcomes among Asian Indian pregnant women with or without gestational diabetes mellitus: A situational analysis study (WINGS-3) |
title_sort | comparison of maternal and fetal outcomes among asian indian pregnant women with or without gestational diabetes mellitus: a situational analysis study (wings-3) |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4911838/ https://www.ncbi.nlm.nih.gov/pubmed/27366715 http://dx.doi.org/10.4103/2230-8210.183469 |
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